Mandatory Enrollment for NHTD and TBI Delayed

The Department of Health (DOH) has provided notice that the Nursing Home Transition and Diversion (NHTD) and the Traumatic Brain Injury (TBI) waivers will now be delayed until January 1, 2017 for mandatory enrollment into Medicaid managed care. NHTD and TBI participants were originally scheduled to be mandatorily enrolled into managed care Jan. 1, and Apr. 1, 2016 respectively. LeadingAge NY had supported legislation that would delayed the transition of the waivers until April 2017 and would have established a work group to help develop recommendations for the transition.

The DOH letter states that they are committed to developing policies and procedures that will promote a smooth transition. They also indicated convening a stakeholder’s work group that will assist in the transition process. The recommendations from this workgroup will be submitted by Aug. 1. They further indicated that they plan to maintain the current fee- for-service reimbursement for two years after the transition.

LeadingAge NY has contacted the DOH to ascertain the status of the proposed rate increases that were in the 2015-16 State budget. DOH has indicated the TBI and NHTD rates have been approved by the Division of the Budget (DOB) but not the Centers for Medicare and Medicaid Services (CMS) as of yet. As we previously reported if the rates are not approved by Oct. 2015 the rates revert back to the rates of Nov. 2014.

LeadingAge NY will keep members informed of the status of the rate increases and formation of the stakeholders work group.

Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871